HomeAnswersMedical Gastroenterologyirritable bowel syndromeWill probiotics and exercise help with IBS over antibiotics?

Can herbal supplements help with IBS better than antibiotics?

Share

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At February 13, 2023
Reviewed AtOctober 16, 2023

Patient's Query

Hello doctor,

Is it fine to stop Satrogyl after one dose since I have finished five days of antibiotics, four days of Oflotas Oz, and one day of Satrogyl O. I have been anxious before eating out for five days ago with work stuff, and I have already been suspected of IBS before? Is it okay for me to stop antibiotics and just maybe focus on my stress and exercise and have only probiotics? I prefer antibiotics as little as possible and would love herbal or natural alternatives for poorly formed powdery stools. Kindly suggest.

Thank you.

Answered by Dr. Ghulam Fareed

Hello,

Welcome to icliniq.com.

A total of five days of antibiotics is good if you feel your symptoms have improved for which you are taking it. IBS (irritable bowel syndrome) has a very close relationship with anxiety and stress. I would suggest probiotics, but I can not assure you about herbal products and their effectiveness. You should work on your anxiety levels. This will improve overall symptoms, and it helps in normalizing stool consistency as well.

Thank you.

Patient's Query

Hello doctor,

Thank you for the reply.

Is powder-like consistency stool a potential symptom of IBS? I started antibiotics, and after eating out the previous day, and I had diarrhea and an urgency to visit the washroom. Since then, it has been losing consistency, but no urgency to go or no pain, just slight gas. Nothing to be worried about, right? Also, how long will it take to have normal consistency, or is that dependent on my mood and stress? I am currently also having BIOTS-M probiotics. Can I have Isabgol for fiber?

Thank you.

Answered by Dr. Ghulam Fareed

Hello,

Welcome back to icliniq.com.

If antibiotics were started because of infective diarrhea, that means you have a history of eating out. Five days of antibiotics should be good. The bowel will take some time to come back to its normal routine. IBS has multiple presentations. One of them is changing the consistency of stools, and symptoms increase with stress. I suggest continuing probiotics for two weeks and avoiding isabgol for some time. This is good for constipation. In your case, it might worsen bowel movements. I hope I have cleared your doubts.

Thank you.

Patient's Query

Hello doctor,

I have been feeling itching near my stomach below my belly button at night and in other places like my scalp and waist. Reddish spots have come from the itching. Is this connected to my stomach? Should I have deworming medicine? Now the stools are fine sometimes in the day but still need to be better. I am still taking Biots-M.

Thank you.

Answered by Dr. Ghulam Fareed

Hello,

Welcome back to icliniq.com.

You can use simple anti-allergic medicines like the tablet Fexofenadine or Hydroxyzine once daily for a few days for itching and red spots, after consulting your doctor. Usually, such itching does not come from the stomach, especially when you have some symptomatic improvement already. However, have you noticed this after any medicine? If yes, then you have to stop that particular medicine. Biots-M (fructo oligosaccride and activated charcoal) is good for the gut, but you can switch your probiotics to other brands if you recently started and feel this itching is somehow related.

Regarding your deworming question, ideally, check your detailed stool report (stool DR) for infection, parasite eggs, or components in your stools. If positive, deworm yourself. We usually deworm children because of their significant exposure to soil and relatively poor hand hygiene practices. In addition, you can deworm yourself if you feel any risk factors, like recent travel or job-related. Last point, if your itching persists after anti-allergic and the red spots worsen, visit a physician for a physical checkup.

Thank you.

Patient's Query

Hello doctor,

Thank you for your reply.

I usually take a deworming tablet every six months. Would you recommend any specific tablet? The symptoms have improved. Yesterday the stool was fine, and today morning again not well formed.

Thank you.

Answered by Dr. Ghulam Fareed

Hello,

Welcome back to icliniq.com

For deworming, take the syrup or tablet Albendazole (benzimidazole carbamate) 400 mg once after consulting your specialist doctor. After that, you can use any of the two anti-allergic tablets I mentioned. After that, you need probiotics probably for a week more. Try to take yogurt daily as well (naturally occurring probiotics).

Hope this helps.

Thank you.

Patient's Query

Hello doctor,

I did a stool test that came out positive for occult blood. I am very worried. Loose stools have not subsided.

Kindly help.

Thank you.

Answered by Dr. Ghulam Fareed

Hello,

Welcome back to icliniq.com.

To check whether the loose stools are infective or not, a stool DR (detailed report) is necessary. If the infection persists, you will need antibiotics; otherwise, you must manage loose stools with simple anti-diarrheal medicine (only recommended in non-infective diarrhea). Stool occult blood is not for loose stools. This is ideally a screening test for occult gastrointestinal blood loss. Later on, we can decide on a colonoscopy. Sometimes it can also be positive in infections because the infection can lead to microscopic blood loss in stools. Other possible situations are if you have taken iron supplements or a diet containing a significant amount of meat one to two days before the test; this can be a false positive too. What are the medicines which you are on for loose stools these days?

Thank you.

Patient's Query

Hello doctor,

I have just been on probiotics, as the stools were loose. But the last two days were bad. So I did the test. I am worried.

Thank you.

Answered by Dr. Ghulam Fareed

Hello,

Welcome back to icliniq.com.

I have reviewed your attached reports (attachments removed to protect the patient's identity). The test is positive for occult blood and red and white blood cells (pus cells). So occult blood detects the heme part of hemoglobin, and hemoglobin is present in the red blood cells. This is positive due to infective diarrhea.

I would recommend the following:

Consult your specialist doctor, talk to them, and take medications after consulting them.

  1. Tablet Rifaxamin (antibiotic) 550 mg or 400 mg, whichever is available at your end, twice daily, half an hour after breakfast and dinner for seven days.
  2. Continue taking the probiotics too.
  3. Repeat your stool DR reports after 7 to 10 days to recheck.

Wishing you great health.

Thank you.

Patient's Query

Hello doctor,

So it is mostly because of an infection and not because of something serious like irritable bowel disease (IBD) or cancer? I am very worried because online it showed cancer. Do you think I require a colonoscopy?

Thank you.

Answered by Dr. Ghulam Fareed

Hello,

Welcome back to icliniq.com.

For IBD, we check for fecal calprotectin levels, not occult blood. However, for cancer, the occult blood test detects microscopic blood loss, which can be due to colonic polyps or lesions. Therefore, occult blood is not a cancer marker; this test only detects a heme portion of hemoglobin in your stools. So technically, it will be positive in case of infections because it causes inflammation and red blood cells to be excreted in stools. As already mentioned, other possible causes are eating meat, iron supplements, even NSAIDs category of painkillers, etc. Treat your loose stools first, and repeat these tests after 7 to 10 days, as suggested. Rifaxamin is an excellent medicine for sub-acute diarrhea. Take this medicine for a couple of days, and once your stools are better, get a retest done. Colonoscopy screening is ideally indicated at a minimum age of 45 years. And earlier with a family history of colon cancer. Before rushing to colonoscopy, you can repeat this test after treating diarrhea.

Wishing you good health.

Thank you.

Patient's Query

Hello doctor,

But what about the previous antibiotics I had taken and which had not helped, Oflotas-OZ, for example? Since they did not work, does that mean it is serious?

Thank you.

Answered by Dr. Ghulam Fareed

Hello,

Welcome back to icliniq.com.

Sometimes bacterial infection partially responds to the treatment, and the rest can be taken care of by probiotics even. In your case, stool DR is still showing some white blood cells (pus cells). So a short treatment can be considered. I would suggest the same plan, as I have explained in the previous response.

Thank you.

Patient's Query

Hello doctor,

I got a fecal calprotectin test done. Since it is low, what does that mean? Does it mean there are chances of cancer since IBD chances are fewer?

Thank you.

Answered by Dr. Ghulam Fareed

Hello,

Welcome back to icliniq.com.

I have reviewed your attached reports (attachments removed to protect the patient's identity). The normal fecal calprotectin levels mean there is no ongoing inflammation within the colon, suggesting no IBD or major infection within the colon. You are concerned about the fecal occult blood, so you are asking about colon cancer again. The only definitive test to rule it out 100 percent is a colonoscopy. My clinical suspicion in your case is very low, as I explained before about the occult blood test. I recommend you take good probiotics and a short course of Rifaxamin for seven days and repeat the occult blood test about ten days later from a good laboratory.

Thank you.

Patient's Query

Hello doctor,

Thank you for the reply. Is fecal calprotectin level high in cancer patients also?

Thank you.

Answered by Dr. Ghulam Fareed

Hello,

Welcome back to icliniq.com.

No, calprotectin levels are high in colon inflammation like IBD (inflammatory bowel disease) or severe active infections like infective diarrhea.

Thank you.

Patient's Query

Hello doctor,

You say my chances of bleeding are low because of IBD or infective diarrhea because my fecal calprotectin levels are low. If IBD and infective diarrhea are ruled out, does that increase the chances of cancer diagnosis or other serious causes? Since bleeding is present and IBD and infective diarrhea chances are low.

Thank you.

Answered by Dr. Ghulam Fareed

Hello,

Welcome back to icliniq.com.

Let me explain again,

1) Your stool occult blood was positive on the stool sample, which already contained red and pus cells. When your sample has red blood cells, so by default, occult blood can be positive because occult blood detects the heme part of hemoglobin, which is protein, and it is present within the red blood cells.

2) You are confusing occult blood tests positively with colon cancer by default due to online interpretation without clinical context.

3) Occult blood tests were introduced to check minimal possible blood loss in the colon, so patients should be filtered for colonoscopy with one of the possibilities (out of many) of having colonic polyps or cancer.

4) This test is not diagnostic for colon cancer or polyps, and this has false positive and false negative results too.

5) I mentioned a few conditions like a recent colon infection and the use of certain medications like NSAIDs, group pain killers, Aspirin, a high meat diet, etc., which could lead to false positive results.

6) Fecal calprotectin levels are different tests, and this calprotectin protein is present in white blood cells, not red blood cells. Its raised levels suggest inflammation within the colon due to IBD or infection.

7) Fecal calprotectin will not rule in or rule out colon cancer.

There are two options in your case: Wait and watch, take Rifaxamin and probiotics, and repeat the occult blood test in 7 to 10 days.

And the other is to go for a colonoscopy for your satisfaction. Regarding clinical assessment and impression, I am not expecting colon cancer with this report at such a young age.

This explanation will help you to decide.

Wishing you good health.

Thank you.

Patient's Query

Hello doctor,

I did a colonoscopy, and the doctor said it was not serious and took a sample for biopsy as they found few blood marks. He said it looked like nonspecific colitis. I await my biopsy reports, but does this rule out colon cancer? If there were a tumor, he would have seen it. What is nonspecific colitis? Is biopsy a routine test?

Thank you.

Answered by Dr. Ghulam Fareed

Hello,

Welcome back to icliniq.com.

Yes, a normal colonoscopy rules out any colon tumor. However, a biopsy is a routine procedure, and we usually do it when we see some inflammation within the colon mucosa. Nonspecific colitis means inflammation within the colon without obvious cause. So if you have the colonoscopy report or picture, I can see the issues, from where they have taken the tissue for biopsy, and the possible clinical cause.

Thank you.

Patient's Query

Hello doctor,

The report says focal punctuate erythema. What does that mean? Is that serious?

Thank you.

Answered by Dr. Ghulam Fareed

Hello,

Welcome back to icliniq.com.

I have also reviewed your attached reports and colonoscopy pictures (attachments removed to protect the patient's identity). Nothing is alarming. This pattern is very common in recent infective colitis. They have taken tissue for biopsy for inflammation and bowel disease, but these are not typical IBD features. So I am not expecting anything serious in this biopsy. However, you may have mild inflammatory changes related to a recent infection or non-specific colitis. There was no evidence of cancer in this colonoscopy, so relax and do not worry.

Wishing you great health.

Thank you.

Patient's Query

Hello doctor,

So according to you, the inflammation is because of an allergy or infection and not because of IBD, and my system should return to normal soon. There is no sign of anything serious. The tumor is ruled out, and a biopsy is just a routine procedure to check the cause of inflammation.

Thank you.

Answered by Dr. Ghulam Fareed

Hello,

Welcome back to icliniq.com.

Yes, these focal erythematous changes are due to a recent infection rather than IBD. I expect nothing serious at your age with otherwise normal health status. I have reviewed your colonoscopy report, and there was no mass lesion or cancer. They have done a biopsy to check this focal erythematous area. We usually perform biopsies when we find any mucosal abnormalities like inflammation, erythema, etc.

Kind regards,

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Ghulam Fareed
Dr. Ghulam Fareed

Medical Gastroenterology

Community Banner Mobile

iCliniq's FREE Newsletters

Expert-backed health and wellness information, delivered to your email.

Subscribe iCliniq
By clicking Subscribe, I agree to the iCliniq Terms & Conditions and Privacy Policy and understand that I may opt out of iCliniq subscriptions at any time.

Ask your health query to a doctor online

Medical Gastroenterology

*guaranteed answer within 4 hours

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.

This website uses cookies to ensure you get the best experience on our website. iCliniq privacy policy